Care Home: Fairview

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What the care home does well The service provides a good standard of accommodation for the people that live at the home, both in communal and personal areas. The service is run in a way that gives people choices about their daily routines. People who live at the service spoke well of staff and said they liked living at the home. Staff cared for people in a way that promoted their dignity. What has improved since the last inspection? A large new conservatory had been erected in the rear garden. Bedrails are now covered. The safeguarding and complaints polices and procedures met regulatory requirements. The home`s policies and procedures have been reviewed and updated. What the care home could do better: All staff need to be provided training on managing aggression and working with people who present challenging behaviours. The range of activities available to service users should be expanded upon with more variation of interests available. Records of activities should record all activities and interests offered on a day to day basis. Staff who are involved in providing activities and interests to service users should receive training for this role. The frequency of service users meeting should be increased, with records kept of discussions and decisions made. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Fairview 68 Freeland Road Clacton On Sea Essex CO15 1LX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alan Thompson     Date: 1 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Fairview 68 Freeland Road Clacton On Sea Essex CO15 1LX 01255427150 01255430908 cathycovey@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Paul Wilkinson Name of registered manager (if applicable) Mrs Catherine Covey Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: One person, under the age of 65 years, who requires care by reason of a learning disability who also has a physical disability and whose name was supplied to the Commission in April 2003 Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 5 persons) The total number of service users accommodated must not exceed 5 persons Two named service users, over the age of 65 years, who require care by reason of a learning disability, whose names have been made known to the Commission Date of last inspection Brief description of the care home Fairview is a residential care home for up to five service users who have a learning disability. One service user also has a physical disability and three of the current service user group are over 65 years of age. The home is located in a semi-detached Care Homes for Adults (18-65 years) Page 4 of 29 care home 5 Over 65 2 0 0 1 Brief description of the care home property in a residential area in Clacton on Sea. The local shops, cinema, theatre, sea front and hospital are within a half-mile radius. Each service user has their own room, two of the rooms have ensuite facilities. A further bathroom/shower room and separate toilet are found on the first floor, with a ground floor separate toilet. Alongside this there are communal facilities of a lounge, dining room, two conservatories and a rear enclosed garden. Service user accommodation is found on the three floors of the home. The office/training room for the home is found in a detached building in the garden, with further office accommodation on the second floor of the home. At the front of the property there is a paved area and offstreet parking in the driveway. The weekly fees are discussed on an individual basis with the home as the exact amount will depend on assessed individual care needs. CSCI inspection reports can be obtained from the home, or via the CSCI internet website, www.csci.org.uk. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection took place on Friday 14th November 2008. (Our most recent inspection prior to this was on 15/11/2007). The content of this report reflects the inspectors findings on the day of the inspection along with information provided by the service and feedback by service users, staff and other parties. The manager was at the home and dealt with the inspection process. Discussions were entered into with the manager, service users, visitors and staff on duty. CSCI survey questionnaires were also provided to service users, staff and stakeholders. Feedback received has been included within this report. Random samples of records, policies and procedures were inspected and a tour of parts Care Homes for Adults (18-65 years) Page 6 of 29 of the premises and grounds took place. The Annual Quality Assurance Assessment (AQAA) should have been completed by the service manager and sent to us to us prior to the inspection. This document gives homes the opportunity of recording what they do well, what they could do better, what has improved in the previous twelve months as well as their future plans for improving the service. Unfortunately we did not receive this document in time to include any information and details from it in this report. All matters relating to the outcome of the inspection were discussed with the manager of the home, with full opportunity for discussion given and/or clarification where necessary. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering moving into the home can be confident that the admission processes ensures that the home can meet their needs. Evidence: The homes Statement of Purpose and service users guide were seen, and included the information needed to help new services users make an informed choice when considering moving into Fairview. Information was easy to read and includes pictures and photographs. The current service users are placed and funded by local authorities. The manager said that no new service users had been admitted since the last inspection, and in fact none had been admitted since the manager took up post at Fairview in 2004. Therefore we looked at a file for a person admitted prior to 2004. The manager added that the current process for assessing a prospective new service user would include inviting the person to visit the home and to spend day stays and perhaps overnight stays before deciding to move in. The current assessment format Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: was looked at and included headings needed to ensure that the right areas of need were considered by staff. These were, biographical information, emotional wellbeing, lifestyle, mental agility, physical health and wellbeing, medication, diet, interests and personal care needs. There was a risk assessment, a nutritional assessment and an overall summary overview of the persons needs and preferences. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information in care plans ensures that individuals needs could be met in a way that they would wish. Evidence: Four individual support care plan files were inspected. These had risk assessments with guidelines for staff on methods to minimise risk. Risk assessments had been reviewed regularly. One assessment included an identified risk of verbal & physical aggression. However when looking at staff training for managing aggression there was no evidence to confirm that all support staff working with service users had received this training. Daily care needs were listed under individual headings which included, daily living skills, medication, personal hygiene, financial support, social activities, mobility, safety and health needs. Each area of need showed a primary goal and how this was to be achieved, along with the actions required from staff to fulfil this. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: All care plans had been regularly reviewed with monthly reports compiled by keyworkers that included progress on the persons health & hygiene, social needs and overall development. Review notes were also seen for a review carried out by social services for one service user earlier in 2008. This meeting included the service user and an advocate. Healthcare issues were seen to be recorded including visits to medical professionals, hospital visits, GP consultations, dentists, opticians, dieticians and chiropodists. A dentist visits the home to carry out check ups and if treatment is needed this is carried out at the dental surgery. Service users are weighted monthly and a body chart form has been devised since the last inspection for use by staff if needed. No service user meetings had been held since the last inspection. The manager said that service users views are listened too on a day to basis, and service users spoken with said that staff listen to them and take account of their views and preference around day to day life in and out of the home. However we would recommend that house meetings include service users and that their views and opinions are recorded to further evidence that they are listened to. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can expect their interests and preferences to be supported by staff. Meals and mealtimes are flexible and meet with the lifestyle of service users living at the home. Evidence: The manager confirmed that none of the service users living in Fairview is currently in any form of paid or voluntary employment, but one person does independently attend, by choice, a local college where they participate in courses. The manager said that some activities are engaged in by service users but individual records of these had not been kept, although some limited evidence of activities was seen in the daily records. The manager added that staff do suggest activities but most service users choose not to take part in many of these, unfortunately there were no Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: records of this. The service user who goes to college also has regular weekly trips out with a carer. These trips include cinema, shopping and shows. Staff said that two service users prefer to stay in doors, one does puzzles in the lounge, and one prefers to stay in their room and watch television. We accept that service users must be able to choose whether they participate in activities and interests however there was insufficient evidence available for us to confirm that the range of activities offered by staff was varied, interesting and stimulating. We also noted that care staff did not have any specific training for the role of activities provision. Three service users see their families and friends regularly, records had been kept of visits as evidence that family contact is supported. Staff on duty confirmed that they respect peoples privacy and enter bedrooms only with the individuals permission, unless the welfare or well being of the service user is in question. Throughout this inspection staff were observed to interact appropriately with service users and appeared to always use the individuals preferred form of address. Discussions were seen to take place and the atmosphere in the home was relaxed and friendly, service users told us that staff were helpful and supportive, and took note of their opinions and wishes. Nutrition records were inspected and evidenced a varied and balanced diet. The manager said that service users can eat in the dining area next to the kitchen or their rooms. Breakfast and lunch are taken at times according to service users choices and their daily routines. The main daily meal is in the evening, when generally everyone eats together. Menus are on a four week rotation and the manager confirmed that service users food preferences and likes/dislikes form the basis of menu planning. Provisions are ordered in so food shopping trips do not occur, however service users may help prepare the meal if they choose. Comments from service users regarding the food included, the food is top class, the food is usually ok, I get enough to eat. Care Homes for Adults (18-65 years) Page 15 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Fairview can expect to receive support in an appropriate and dignified way that meets their needs. Evidence: Care records and discussion with service users and staff confirm that service users are fully supported in making their own choices around clothing styles, hairstyles and general appearance. Assessment records included preferences around rising and retiring times and details of the levels of personal; care support required was also seen to be documented. Service users spoken with, who were willing, when asked to fully express a view as to the support provided them by staff, did confirm that they liked the staff and were satisfied with the care provided them in the home. Actual comments made included I like the staff. Care plans contained assessment of healthcare needs. The current service user group are offered staff support and guidance in recognition of their individual healthcare Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: needs and to access community healthcare facilities. Service users regularly visit community based healthcare services including dentists, some with staff support and one independently. Service users healthcare needs were seen recorded within individual care plans and updated in the daily care notes. All service users accommodated were receiving full staff support with their medication needs. Service user files included a signed form consenting to staff providing this support. Some of the current service users did not appear to have a full understanding or awareness of the medical reasons for medication regimes prescribed to them. The Manager confirmed that if service users refused medication then advice and encouragement is offered to them to understand the reason for the prescribed dosage. The homes written medication procedure/policy clarified policies on ordering, receipt, storage, administration, record keeping and disposal of unused medications. A random sample of medication administration records and stocks of current medication were inspected. No errors were noted. The manager provides staff training on medication. The package used is based on Skills for Care standards and covered legislation, controlled drugs, record keeping, the monitored dosage system, storage and disposal of unused stocks. Certificates to evidence completion were seen. Staff who handle medication had also been put through an in-house medication competency assessment, records of this were also seen. Care Homes for Adults (18-65 years) Page 17 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Practices in the home safeguard service users and ensure that concerns are listened to and addressed. Evidence: There was a complaints procedure in place, which clarified the complaints process and the timescales that the manager should investigate and respond to the complainant. There was also a pictorial style complaints procedure in the home. Some service users would not have the ability to follow any written procedure, but the document displayed clearly indicates to service users that they have a right to tell somebody if they are unhappy. Comments from service users confirmed that if they were unhappy they would tell a member of staff or somebody else. There was a set template form for recording complaints and a complaints record. There had not been any formal complaints recorded since the last inspection. All but one of the service users have active involvement with their respective families. The manager also confirmed that the home has active links with a local advocacy service and was able to demonstrate that this service is used as appropriate to ensure that service users wellbeing is paramount to any given situation. The home had a copy of the safeguarding adults policy and procedure produced by the Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: registered provider, and a copy of the latest joint safeguarding procedural guidelines issued by the Essex joint authorities on abuse issues. These documents included detailed guidance for staff on the adult protection procedures and on types of abuse that may occur. Staff are given safeguarding awareness training during their induction and following this undertake regular in-house refresher training on this subject. Certificates were seen for this. Staff spoken with understood what was meant by safeguarding adults from harm and said that if they had any concerns that abuse had occured then they would contact the manager. There was a written whistleblowing policy which clarified staffs responsibility to report any suspected abuse. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users live in a comfortable, clean and homely environment. Evidence: During the inspection a partial tour of the home was made accompanied by a member of staff. The home was clean and was well maintained, furnished and decorated. All five bedrooms are singles and three of the rooms have en-suite wc with one also having a bath and another a shower. A further bathroom/shower room and separate toilet are found on the first floor, with a ground floor separate toilet. The manager confirmed that service users are provided full opportunities to personalise their rooms to their own tastes and requirements, and rooms inspected included various items of personal possessions according to individual choices. Some service users spoken with showed the inspector around their rooms and said how comfortable and homely the home is. The lounge was well furnished and looked comfortable. The dining area next to the kitchen was small but contained the facilties needed for the size of the home. The laundry room was at the rear behind the kitchen, with separate access so that staff did not walk through the kitchen with dirty laundry. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: The garden is compact but well laid out, and has a patio with a table and seating. Since the last inspection a large new conservatory has been built in the rear garden to provide service users with an additional sitting area. Some service users work together with staff to ensure that their home is kept clean and tidy, others rely on staff to keep their rooms clean. Those spoken with said that they liked their rooms and they were kept clean. On the day of the inspection the home was bright, cheerful, clean and hygienic. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from being supported by a staff team who had been mostly trained for their roles. The recruitment procedure in the home provides the safeguards to ensure that appropriate staff are employed. Evidence: A clear organised staff rota was available for inspection and was seen. On the day of the inspection four service users were living Fairview and daytime staffing were a minimum of two support workers. At night there is one sleeping in member of staff with someone on-call close by as support. The manager works at Fairview and a sister home close by and divides her time between the services. Staff recruitment records were in good order and included an application form, proof of ID, photo, a CRB check, two references, job description and contract of employment. New staff are subject to a probationary period during which time they receive in-house induction training covering safety, medication, food hygiene, health & safety and fire safety. After completing this they move on to the Skills for Care Common Induction standards for social care workers. Evidence of this was seen. New workers are also encouraged to commence NVQ level 2 training. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: Staff training records had been kept in files. These comprised an overall record of training undertaken and certificates of attendance on courses, which included, induction, abuse, food hygiene, NVQ, health & safety, infection control, fire safety, first aid, epilepsy and medication. Most of this training is provided in-house by the manager who is qualified to provide this on several subjects. As previously noted on page 12 of this report service user risks assessments included an identified risk of aggression being displayed. Unfortunately the training records we looked at did not confirm that all staff had been trained to meet this need. Staff spoken with confirmed they were well supported by the management team. They also said that they had been offered good training opportunities, which they thought were appropriate to their roles. Staff were open, friendly and demonstrated sound care values. The observed rapport between staff and service users was relaxed and friendly. Service users spoken with said they liked the staff and that staff helped them to keep their rooms tidy, and the food they cooked was good. Staff supervision meetings had taken place, with records kept of the agenda discussions and actions. Areas included had been service user issues, team issues, responsibilities, key worker role, performance and training needs. The homes supervision policy provided guidance to staff on the reasons for regular 1 to 1 meetings as an important support forum. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Fairview can be confident that the home is managed effectively and that their opinions are central to how the home is run. The environment appeared safe. Evidence: The registered manager is a qualified nurse, has completed the NVQ4 Registered Managers Award and had 15 years experience in the management of a care setting. Comments from staff about the management of the home included I feel confident in my management that if I have any problems with my work I can go to them for advice, and we have good management. The registered providers quality assurance process includes sending annual surveys to service users their families and to staff. Surveys to service users include easy read symbols. Views gathered covered, the information provided about the service, safety, comfort, staffing and staff attitudes. Completed forms returned are reviewed by the Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: manager and an analysis form compiled showing outcomes of any resulting actions taken. Record keeping was looked at and random samples of records required to be kept by regulation were inspected. These included, the statement of purpose regulation 26 reports (monthly registered person report), staff rota, visitor book, nutrition records, assessments, care plans, staff recruitment, complaints, medication records, regulation 37 notifications, service user monies held for safekeeping and fire drills. All were acceptable with the exception that evidence was not available to confirm the providers regulation 26 reports had been completed monthly. Staff had received training in first aid, fire safety, health & safety and food safety. Service records were seen to show that the homes hoists, fire alarms, fire equipment, emergency lights, gas systems, the electrical installation supply and portable electrical appliances had all been tested/serviced within recommended timescales. The manager confirmed that hot water supply is regulated at or near 43 degress celcuis, and that weekly checks on this take place. Records of this was seen. There was a fire risk assessment and a new health and safety check on the premises had begun. This looked at perceived hazards, equipment and the condition of facilities. Care Homes for Adults (18-65 years) Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 32 18 Staff must be trained in managing aggression and challenging behaviours. This is to ensure that staff are trained for the roles they perform. 31/03/2009 2 41 26 Regulation 26 visits (registered provider visits) must take place on a monthly basis with reports available for inspection. To evidence the appropriate support from the provider and ensure improvement in the home. 31/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 8 The frequency of service users meetings should increase to show that service users are encouraged to participate in the decision making process in the home. Care Homes for Adults (18-65 years) Page 27 of 29 2 3 4 14 14 14 Records should be kept of all activities and interests offered to and participated in by service users. The range of activities and interests offered to service users should be expanded upon. Staff who are responsible for providing activities to service users should receive training for this role. Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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